a. Letting high technology centers that can provide quality care at a reduced cost compared to centers that desire the high technology equipment and highly trained personnel then charge Medicare and Medicaid, insurance companies and private individuals for a less quality and relatively more expensive care might be a good place to start.

b. Drug costs must be controlled. When Congress opened the doors to the drug manufacturing industry and allowed extreme costs to be paid by government programs we all lost. This action escalated medication costs to all segments of society while many of those who lobbied congress for these changes later went to work for the same drug manufacturers.

c. Malpractice claims must be reasonably controlled.

d. Hospitals must no longer be allowed to inflate patient costs through marketing, use of high technology and accounting practices that serve only to increase their revenues. When a patient goes to the hospital emergency room with a temporary neuritis caused by resting his elbow on a table or recliner and then has EKG’s, chest xrays, cat scans and MRIs, a series of blood tests, and then hospitalized for 18 hours and charged $ 17,000 something is wrong. A well trained physician should make the diagnosis of funny bone pressure in a matter of minutes. Or a patient has a simple hernia operation under local anesthesia, is kept overnight and the next day discharged with a $ 30,000 bill something is wrong.

e. Last it has been proven that for every dollar spent on prevention there is a $4 savings in health care costs later. Prevention not only saves health care costs it also improves quality of life in most cases.

3) Earlier this year I visited Norway. Their quality of care is exceptionable and their cost for health care from cradle to the grave is much less expensive. The citizens there love it. High technology procedures there are performed in one of three university hospitals. Each of these three hospitals is designated for different types of care. Not only is the quality of care for a specific health need better the training of medical personnel, technology and laboratory support for the more complex procedures such as brain surgery, open heart surgery and the diagnosis of certain rare conditions is less costly to the government. The patients benefit and do not complain even if special transportation is required for emergency care.

J. Dale Simmons, MD

Lake Wales, Fla.

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